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22D-039 (7) BP-2023-0242 100 RYAN RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 22D-039-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-0242 PERMISSION IS HEREBY GRAN ,ED TO: Project# ROOF 2023 Contractor: License: SAMBRICO LLC/VISTA HOME Est. Cost: 27000 IMPROVEMENT 107644 Const.Class: Exp.Date: 08/19/2023 Use Group: Owner: R BUTCHER JAMES W&KAREN Lot Size (sq.ft.) Zoning: WSP Applicant: SAMBRICO LLC/VISTA HOME IMPROVEMENT Applicant Address Phone: Insurance: 2097 RIVERDALE ST 413-382-0249 UB-2E072183-22 W SPRINGFIELD, MA 01089 ISSUED ON: 02/28/2023 TO PERFORM THE FOLLOWING WORK: STRIP AND RE-ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VI LATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ,2 Q� Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 7„ The Commonwealth of Massachus�l''t , _ OR VW Board of Building Regulations and St �� 1VIUNIF PALITY Massachusetts State Building Code, 780 �2 JO� USE Building Permit Application To Construct, Repair, Renovat�- emffiish a . Revis td Mar 2011 17 One-or Two-Family Dwelling \1,,-, This Section For Official Use Only Building Permit Number: c P• ,1,3—2 y . Date Applied: /4:Ua/L) Zs ,/1 Z ZS 2oz 3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers tDo pyc,L✓1 f �ik 1.1a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: etintS ) lutvCr1 Ou-IC -r Florn cc t- l6�c. .ft- O Name(Print) City,State,ZIP 00 (21/4/o+n 42-0k (41s)irl--94ra 3 j.6 ut-c.►-e—v( co.%-,c.ci.r+.tiu Jr. No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other .X?Specify: 11po A-•`�qn Brief Description of Proposed Work': (Lcvi,o ve- t G,vr t- Gt.5 tp V► a.0— 5hiN ice.. V rb0 F`et car -t v �to. . W l o.5? ' s1n3• O Ne+- coar:)n•, b.-vac-. o v�a-v Sv✓1 ✓eo rrt - Ca P.4' 1 CL T wwo,1-Er . Yt Vch-vieat c-Itic.t.vvtst-- SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ Z7,000 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ 0 ❑Total Project Costa (Item 6)x multiplier x 3.Plumbing $ 0 2. Other Fees: $ 4. Mechanical (HVAC) $ O List: 5. Mechanical (Fire Suppression) $ Total All Fees: $ Check No.a iaurCheck Amount: "" Cash Amount: 6. Total Project Cost: $ 2:710 Ot ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C- —101to444 SII9ks23 Ir24`C I •, Ss� License Number Expiration Date Name of CSL Holder V List CSL Type(see below) V 8 co.stg.).1 r,nt, No.and Street Type Description 1/4: fj do hc.Arin 1✓ A- coyO95 Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry ��Y h` RC Roofing Covering '� -' 10 rnvA. n �' �'�lA WS Window and Siding SF Solid Fuel Burning Appliances 3ra- d a ut9 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) vt3+0, �o 1 ko 0St "tlp a-s n'1 r►'�`^'�"-4-Q +1f' HIC Registration Number Expiratio I Date HIC Company Name or HIC Registrant Name 1r)c11 .w.a-GL&k. S - NICt1CP•A iv.I'LON•va. v r0✓' vt 1'. Lea✓lt No.and Street Email address vd .Sptrtck M.A- O►oS (413)3Sa y9 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .)5C No . ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize_ J 1 1 C_ trA.CR VI,Q I Wl(Jr 1.A..LbL)-1-Lj -- to act on my behalf,in all matters relative to work authorized by this building permit application. L c Cool`rats, Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. • Print O er's or thorized Agent's Name(El onic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,fmished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton r Massachusetts •„ • DEPARTMENT OF BUILDING INSPECTIONS +n , 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: IS 140l1 on 126OO trdi`ei Ot Cr 0(9°ea. The debris will be transported by: Name of Hauler: USA- ) /adul " J Signature of Applicant: Date: _c _j__71_92 The Commonwealth of Massachusetts !,` • ;r Department of Industrial Accidents a 9.__ ' 1 Congress Street, Suite 100 1 ' 4 Boston, MA 0211-1-20/' ; ' www mass.gova/dia il oaken' t'untpensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. I t)RI. FILED WITH THE PERMITTING:Al1THORITY. Applicant Information Please Print Le_ihhi Name ttiusinessiorganizauonitndividual): v 15+e.. `-tovv\s_ 1 W4 pv-kltA.2.ln.AtR...y"la; Address: c2 C (( .t`,,,-.Q..C.\ ..c. sn- City/State/Zip: 1N LS'r SeF421 M A- 0105,41 Phone#: Lf 0 3 -- 0.-e,•L1°% Are you an employer?Cheek the appropriate biz: Type of project(required): 1.®I am a employer with , , employees(full=bur part-time).• 7. 0 New construction .?.n I am a sole proprietor or pamerahip and have no employees working for me m 8. 0 Remodeling any capacity.[No workers'comp.insurance n_quurnl.[ 30 1 am a homeowner doing all work myself.[No workers'comp.insurance required.'' 9. ID Demolition 4.0 I am a hortmeowncr and will be hiring contractors to conduct all work on my property. 1 will 10 El Building addition ensure that all contractors either have workers'compensation insurance or are sole no Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5 am a general contractor and I have hired the sub-contractors listed on the attached sheet_ These subcontractors have employees and have workers'comp.insurance. 13❑Roof repairs I4 2Othet V'"" .7 Y 6.0 We arc a corporation and its officers Ihav a cxenised their right of exemption per M(iL e. 152,yv 114).and we have no employees.[No workers'comp.insurance requiredd.] •Any applicant that cheeks box ttl must also till out the section below showing their workers'compensation policy information. *ilormowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new attida%it indicating such. :Contractors that cheek this box must attached an additional sheet show Inc the name of the sub-contractors and state whether or not those entities base employers. If the sub-contractors have employees.they thrust pros(de their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.Insurance Company Name: 50vt"h (A) - 2—.. 1 - . .__.__ Policy#or Self-its. Lie. 4: ( ^ZL`.c>12.14?-2 . Expiration Date: 3 1 Z. Job Site Address: 100 ►kee) e C City/State/Zip: �'4ev-w, PA 4- 01 die a Attach a copy of the worke compensation policy declaration page(showing the policy number and espi lion date). Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a fine up to SI,500.00 and ur one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury fluff the information provided above is true and correct. Signature: g ��� Date: o2/I?/ elf3 Phone#: oZ Official use only. Do not write in this area,to be completed by city or town official. t'itt or Town: Permit/License# Issuing.tuthuritl (circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ('antra Person: Phone#: City of Northampton `t1 1T'r4i.. l Massachusetts ,,„ -- `...ee Ir �, (� DEPARTMENT OF BUILDING INSPECTIONS s .� 4 � � 212 Main Street • Municipal Building _, i,� --°�� Northampton, MA 01060 is!-k, 1,--‘0 HOMEOWNERS'EXEMPTION ELIGIBILITY ', FIDAVIT I, NA-CA" 7 1 C A...L-5 I" -1A.9. 'r (ins' t full legal name), born (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeow ers' exemption to the permit req ,irements of the Massachusetts State Building Code, codified at 780 CMR 10.R5.1.3.1, in connection with a pro)•ct or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for w eh I am seeking the aforementioned home. ers'exemption, does not involve the field erection of manufactures buildings constructed in accordance with 780 1 MR 110.R3. 3. I qualify under the State Building Code's deft ition of"homeowner"as defined at 780 CMR 110. '5.1.2: Person(s) who owns a parcel of land on hich he/she resides or intends to reside, on w 'di there is, or is intended to be, a one-or two-family dwelling, attached or detached structures access.ry to such use and/or farm structures. A person w'o constructs more than one home in a two-year per'od shall not be considered a home owner. 4. I do not hold a valid Massachuset s construction supervision license and, except to the extent t at I qualify for and will abide by the Massachus' is State Building Code's requirements for the supervision of th; project or work on my parcel, I am not engag;' in construction supervision in connection with any project or work involving construction, reconstruction alteration, repair, removal or demolition involving any activity r•gulated by any provision of the Massachus tts State Building Code. 5. If I engage any other p'rson or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge i t I am required to and will act as the supervisor for said project or work. Signed under the pains an :enalties of perjury on this *D—day of 1-/ , 2001 SC_. Cu VI, k- (Signature) AL-cwt.) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `...� 5;4/2 21 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACr- NAME: Certificate Department A-Costa Insurance Agency Inc Am,No,Ext): 508-875-3488 ram,Np): 508-875-9388 1 FRANKLIN COMMONS ADDRESS: coi@a-costains.com INSURER(S)AFFORDING COVERAGE NAIC X FRAMINGHAM MA 01702 INSURER A: Atlantic Casualty Ins Co 42846 INSURED INSURER B: PROGRESSIVE 24252 GOLDEN CREW CONSTRUCTION CORP INSURER C: Hartford Underwriters Ins.Co. 30104 20 Timrod Dr INSURER D: UNIT A INSURER E: Worcester MA 01603-1246 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD SWVD POLICY NUMBER (MDDYYY IIY) (MM DD1 1YCY-YEYYY)) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR UAMAG*IU KEN IEU PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 1,000 A AC14778750PC 5/4/2022 5/4/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 40,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 20,000 8 ALL OWNED SCHEDULED 04409910 4/26/2022 4/26/2023 BODILY INJURY(Per accident) $ 100000 AUTOS x AUTOS — NON-OWNED PROPERTY DAMAGE $ 5 000 HIRED AUTOS AUTOS (Per accident) $ • UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? N NIA 1326760 5/4/2022 5/4/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under --— DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN VISTA HOME IMPROVEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 2097 Riverdale St AUTHORIZED REPRESENTATIVE West Springfield MA 01089-1C25 If dnai ��WIti0 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD (it—elRl7A CERTIFICATE OF LIABILITY INSURANCE [DATE(MM/DD/YYYY) �sc�� ns/220027 T TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsementksj- PRODUCER CONTACT NAME: SOUTHWICK INS AGENCY INC PHONE FAX P O BOX 100 (A/C,No,Ext): (A/C,No): E-MAIL SOUTHWICK.MA 01077 ADDRESS: 28TKC INSURER(S)AFFORDING COVERAGE NAIL u INSURED INSURER A: IR-1,.L_i L,..PR:iPEP 1 V C ASI A.", ,»ILIA•.• or A,A1FR'.0 X 1 SAMBRICO LLC DBA VISTA HOME IMPROVEMENT INSURER B: INSURER C: INSURER D: 2097 RIVERDALE STREET INSURER E: WEST SPRINGFIELD. MA 01089 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rtDDLAUBR POUCY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (HIM\DD\YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ .- CLAIMS MADE n OCCUR DAMAGE TO RENTED $ - PREMISES(Ea occurrence) MED EXP(Any one personi $ PERSONAL 8 ADV INJURY $ GENII_AGGREGATE LIMIT APPLIES PER. GENERAL $ I AGGPEGCTEROJECT aLOC E?OJCY PRODUCTS-COMPIOP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLE $ - ANY AUTO LIMIT(Ea accident) BODILY INJURY $ ■ OWNED SCHEDULE AUTOS (Per person) AUTOS ONLY111 BODILY INJURY S HIRED � NON-OWNED AUTOS ONLY AUTOS ONLY (Per accident) PROPERTY DAMAGE $ I (Per accident), $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DECI. RETENTION $ l' $ WORKER'S COMPENSATION AND PEp OTHER EMPLOYERS LIABILITY S T f T IiTE AVY PROPERITOR/PARTNER/EXECUTIVE YIN UB-2E072183-Z2 03/12/2022 03/12/2023 E L.EACH ACCIDENT $ 5C0.000 O:.F!CER/MEMBER EXCLUDED? (Mandatory in NH) 0 NIA E L DISEASE-EA EMPLOYEE $ 500,000 ryes.describe OF er O E L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE INSUREDS MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS F R CLAIMS MADE BY THE INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA NO AUTHORIZATION IS GI\EN TO PAY CLAIMS FOR BENEFITS IN STATES OT ER THAN MA IF THE I BSI_KFD HIRES.OR HAS HIRED EMPLOYEES OLTSIDE OF MA THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA CERTIFICATE HOLDER CANCELLATION VISTA HOME IMPROVEMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 2097 Riverdale St BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE.�� West Springfield MA 0 7 089-1 025 VV ACORD 25(2016103)(Rev.09-18) The ACORD name and logo are registered marks of ACORD 1988- 15 A ORD ORATION. ghts reserved. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regutat ons and Standards C:anstructipn Supervisor CS-107644 Expires. 08e 19;2023 RICK A LAJEUNESSE 8 COOLEY DRIVE WILBRAHAM MA 01096 I1 Commissioner > ' THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration w �^ Type. LLC MRegistration: 162058 SAMBRICO LLCExpiration 01/02/2025 D/B/A VISTA HOME IMPROVEMENT xfititi, 1?"2097 RIVERDALE ST ; WEST SPRINGFIELD, MA 01089 ,. r 1, _ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE: LLC Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 162058 01/02/2025 Boston, MA 02118 AMBRICO LLC /B/A VISTA HOME IMPROVEMENT l RIAN RUDDPi)(\ ''' )97 RIVERDALE ST y�4,'vole,/ oeft i( '�' �`' ' - 'EST SPRINGFIELD,MA 01089 - I Inrlarsarratary NM'valid without cinnafurn Page 1 of 7 2097 Riverdale Street MA Lic# 162058 West Springfield, MA 01089 CT Lic#0621848 Vista9IP �� = 1' lr1TINlIM vistahomeim rovement.com / • re�FraaencoNTancroa Phone: 888.597.2323 HOME IMPROVEMENT p Fax: 413.382.0241 Nor'Easter Roofing Contract All home improvement contractors and subcontractors must be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA 02116 Phone: 617.973.8700 Customer Information James Butcher (413)387-9883 Date: 12/20/2022 Karen Butcher j.butcher@comcast.net Rep: John Lee 100 Ryan Rd Florence MA 01062 Roof Specifications Nor'Easter Roof Systems Platinum Roof System Color Sierra Grey Drip Edge Color white Number of Layers 2 Attic solid plank boards Tear Off/Shingle Over tear off Location Partial please detail on diagram Underlayment Nor' Easter Deck Defense Ice&Water Shield 6feet Supply and Install Ridge Vent yes Vista Home Improvements agrees to do the following: Supply Dumpster Included Dumpster location Driveway Inspect Decking for damage Yes Replacement decking price per sq ft 5.75 Replacement decking price per sq ft Ice and Water all valleys, penetrations, eaves and chimneys Yes Supply and install pipe boot flashing Yes Total Job Clean-Up Yes Cut In New Ridge Vent Included Frame In Or Close Off Gable Vent(s) 2 Large Chimney Relead 1 This space intentionally left t:,J. <A. Page 2 of 7 Additional Details Special Instructions Thank you,and welcome to Vista,James&Karen Do Not Do (We do not do any painting or staining) Soffits/fascia/any additional wood beyond 200 sq ft RF 5&7 ARE EXCLUDED I, James Butcher,Karen Butcher have read the terms stated herein, they have been explained to (me/us), and (I/We)find them to be satisfactory and hereby accept them. Roof Sketch / Photos Butcher �► HOVER Complete Measurements 100 Ryan Road, Northampton, MA ROOF FACETS MIN Roof Facets -..._. Aretu a_. Paco' M llld NIB Pc a 1611 ft S/12 RF-2 270 R' Vt2 7*-3 3N h' S/12 RIF-4 VS R' S/12 RF-S 71 R' 2/12 NM OF 027Pt' S/12 RF-7 202 R' 2/12 //..\ '• Illllllle f Illlllll� 1 •a»rMlliia ai.yalMM.r alaMrw+rMlraip.Mr.wiaMiar MwM ,ifttlYiRMMI-I seemp,+gimp HOVER •rw...rri�wwrn�rwr.rr...+.wrwn.w.r.r.w...r+.rwr.wr�+r+�rr..r. who M�Mn'Vir"Im+��a.niilasrww+M••waMar.M.waiMM.eWO OW IONIC 71aQ r....w.....+-..�-w r...........,.w+..............,i ,.....:...............�.-..rw'. swm i..w...r e..�.� 'W Te (ht t'leA (c. 41.Xmbe„,. John Lee,Authorized Representative James Butcher 12/20/2022 12/20/2022 Date Date Karen Butcher 12/20/2022 Date This space intentionally left blank Page 3 of 7 Homeowner's Association NO WORK SCHEDULE Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified herein. Contractor will begin the work on or about 05/20/2023 Barring delay caused by circumstances beyond Contractors control, the work will be completed by 06/20/2023 WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for the period stated below following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, its subcontractors, employees or agents, is discovered after completion of any job, Including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired or replaced, such damage or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Contingent on solar company Warranty Period Lifetime Measure Section Measure Set With -- Rick Date Measure Is set for 12/28/2022 2 hour window Measure is set for 09:00-11:00 Total Contract Amount (All Discounts Applied) $27,000.00 Payment Amount Due Upon Signing Contract(1/3 Maximum) $9,000.00 Amount Due At Start $9,000.00 Amount Due Upon Completion $9,000.00 Form of Payment Upon Signing Check Check# 1092 Check Date 12/20/2022 Acceptance of Proposal I have read both sides of this document and accept the prices, specifications and conditions stated. understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work,as specified. Payment will be made as outlined above. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller, which may be his main office or branch thereof, provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Please refer to the Notice of Cancellation below contents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. NOTICE OF CANCELLATION This space intentionally left blank Page 7 of 7 Contractor, under provisions of Chapter 142A of the Massachusetts General Laws, is required to apply for and obtain all construction related permits. Contractor shall not be deemed responsible for delays in the work described in this agreement caused by regulator, permit granting or inspectional agencies, authorities or individuals. NOTICE: If Owner obtains his/her own construction related-permits for the work described under this Agreement, Owner is hereby advised that in the event of a dispute,judgment and non payment of Contractor, Owner will not be entitled to make claim to or collection from the guaranty fund established in M.G.L. c. 142A. Modification: This Agreement, except as to concealed conditions or delays occasioned thereby or by restarts, cannot be changed except by a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in accordance with the Notice of Cancellation. Owner hereby grants Contractor a limited Power of Attorney to complete incomplete documents on Owners behalf. Completeness of Contract for Execution: Owner is hereby advised not to sign this Agreement unless and until all blank sections have been filled in or marked as void, deleted or not applicable, and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. Attorney's Fees/Costs Owner agrees to pay all costs of collection, including reasonable attorney's fees, cost and expenses. Furthermore, interest shall be charged at the highest lawful rate of interest on any and all overdue payments. Copy of Agreement to be given to Owner: This Agreement is governed by the laws of the Commonwealth of Massachusetts. It must be executed in duplicate, and an original, signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the Owner of a copy therefor. e •••,...1 it I) KA'10-1"-- James Butcher Karen Butcher 12/20/2022 12/20/2022 Date Date goz... 0/4 . John Lee Authorized Representative 12/20/2022 Date This space intentionally left blank